Inspection on 11/07/06 for Tuxford Manor Care Home

This inspection was carried out on 11th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tuxford Manor Care Home 27/06/07

Tuxford Manor Care Home 21/11/05

Tuxford Manor Care Home 13/06/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Tuxford Manor Care Home 143 Lincoln Road Tuxford Newark Nottinghamshire NG22 0JQ Lead Inspector Steve Keeling Key Unannounced Inspection 10th July 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tuxford Manor Care Home Address 143 Lincoln Road Tuxford Newark Nottinghamshire NG22 0JQ 01777 872555 01777 872666 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Hallmark Healthcare (Tuxford) Ltd Mrs Linda Sumner Care Home 45 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (19) of places Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users shall be within categories OP (19) or DE/E (26) within a total registration of 45 21st November 2005 Date of last inspection Brief Description of the Service: Tuxford Manor Care Home provides 45 places for Older People that require residential care. The Home is situated on the outskirts of the town, close to a local public house although transport would be required to access the nearby shopping areas. The accommodation is provided on two floors with a passenger lift to enable easy access for people with restricted mobility. All ground floor and garden areas have level access. The facilities within Tuxford Manor are suitable to achieving optimum independence for the service users at the home. Wheelchairs can access all areas within the home, appropriate mobility aids are available such as hoists, transfer belts and strategically placed hand rails. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 4.25 hour period and involved one inspector. The main method of inspection was case note tracking, this is a method of selecting residents within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the records of the residents to ascertain if the residents identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two residents notes were case tracked. Also as part of the case tracking process, a staff member within the home was informally interviewed to further evidence the quality of care afforded to the residents. It was evident that the registered manager and the care staff on duty at the time of the inspection are very committed to providing a high standard of care for the residents. The manager and staff within the home were very helpful and cooperative thus ensuring that the inspection process progressed in a professional and efficient manner. The fee currently charged at the home range from £350 to £400 What the service does well: Tuxford Manor continues to provide a homely and safe environment for its residents. The inspection process allowed for a partial inspection of the premises, which were found to be clean and fresh with no obvious hazards evident. Residents are encouraged to furnish their bedrooms with personal possessions such as photographs, pictures and small items of furniture to further promote a homely environment. Residents spoken with were very satisfied with the care they received at the home stating that all the care staff employed at the home treated them with utmost respect and dignity. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 6 Staff at the home receive appropriate mandatory training to perform their duties within the home and residents stated that they felt safe within the homes environment. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The assessment documentation provided by Hallmark Health Care had not been fully completed within the case tracked notes. Tuxford Manor does not provide intermediate care services. EVIDENCE: The residents care plans were stored effectively and securely although it was evident that the assessment documentation provided by Hallmark Health Care had not been fully completed within the case tracked notes. The Waterlow score (a tool designed to identify an individuals susceptibility to pressure ulcer formation) for one cased tracked resident was utilised on the 4th January 2006 at which time the resident was assessed as at risk of pressure ulcer formation. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 9 Given the residents susceptibility to pressure ulcer formation the Waterlow score of the resident should be assessed on a more frequent basis. The section within the assessment documentation provided by Hallmark Healthcare, appertaining to the resident’s preferred social activities and preferred sleep pattern was not evaluated at all. The notes of the second case tracked resident revealed that the continence assessment section within Hallmark Healthcare documentation had not performed, although a care plan was evident within the residents notes which addressed the residents occasional urinary incontinence. The registered person should ensure that all sections within the comprehensive pre-admittance documentation are addressed effectively to ensure the holistic needs of the residents are addressed effectively. The manager stated that the home could also offer “trial periods” of residency of up to one month for residents to further establish the suitability of the home in meeting their needs. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. On the whole the residents care plans were effective in addressing the identified residential needs of the residents although some elements within the care planning process had not been effectively evaluated. No service users within Tuxford Manor are responsible for the administration of their own medication at the time of the inspection, although facilities for selfadministration of medicines are available should it be required. The policies and procedure at the home in relation to the receipt, administration and disposal of medicines are effective. Residents at the home are treated with respect and dignity and their privacy is maintained effectively. EVIDENCE: Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 11 Hallmark Healthcare utilises an effective care planning process but it was evident within both case tracked notes that elements of care within the care plans were not fully evaluated and as such not the all identified needs were addressed effectively. One residents care plan specified daily pressure area monitoring, an examination of the daily progress record identified that this element of care was not being documented effectively as the daily records of the resident did not evidence that staff within the home were undertaking this element of care. As far as practically possible all residents or their representatives should be involved in the care planning process to ensure informed consent is obtained. It was evident within one case tracked residents notes that consent had not been obtained from the resident or their representatives as the consent documentation had not been signed. At the time of the inspection no service users were responsible for the selfadministration of medicines. It was established that should a service user wish to be independent in the administration of medicines the manager in conjunction with the resident and the multidisciplinary team which would include the resident General practitioner, would perform a risk assessment, if the resident was deemed as being safe, self-medication would be facilitated. It is necessary to store some types of medication within the controlled environment of a fridge to prevent medication degradation. At a previous inspection it was evident that medication was being stored within a fridge but the temperature had not monitored effectively. It was evident that the fridge temperature is now being monitored effectively on a daily basis and the temperature within the fridge is within the recommended parameters. At a previous inspection a quantity of a controlled drug documented within the controlled medication book did not corresponded to the actual amount of medication available. At this inspection all controlled drugs records were examined and found to be accurate. Medications, dressing and medical equipment are stored effectively and well organised within the medication room. Residents spoken with were positive about the way staff spoke to them. The inspector witnessed interactions between residents and staff at the home and it was evident that staff promoted the principles of respect and dignity at all times. Residents stated that staff always knocked on the resident’s bedroom door before entering and also stated that the staff respected the residents privacy and dignity when bathing or performing personal care. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 12 Staff interviewed demonstrated a thorough knowledge of the principles of privacy, dignity and respect and confirmed that the induction process, which all new members of staff receive, provides information appertaining to respect and dignity. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents at the home are able to participate in stimulating social activities if they choose. Residents are encouraged to maintain contact with their family and friends within the home and within the broader community. Residents are encouraged to exercise choice and control over their lives. Residents are provided with a wholesome, appealing and balanced diet. EVIDENCE: A part time social activates coordinator is employed three afternoons per week. Residents stated that they were, on the whole, satisfied with the social activities performed within the homes immediate environment which includes bowls, bingo, games, quizzes, arts and crafts, dominoes, reminiscence Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 14 therapy, and one to one interventions. The home also provides guest entertainers such as singers and organists for the resident’s enjoyment. A case tracked resident stated that he particularly enjoyed going to the nearby shops, public house and post office in his electric scooter thus promoting social interactions beyond the homes immediate environment. It was established that residents, in the past, have enjoyed day trips with the aid of hired transport but these trips were somewhat infrequent, as the home does not have its own transport at this time. The manager, staff and the case tracked residents confirmed that no restrictions are in place in relation to visitations. Residents stated that the staff are always friendly and courteous towards their family and friends and that visitors enjoyed coming to the home. Residents spoken with were very well presented, dressed in appropriate clothing for the season, and were wearing their own shoes or slippers. Residents spoken with stated that the laundry service is efficient and that their cloths are returned promptly from the laundry. It was evident that the food provided at the home is wholesome, nutritionally appropriate and varied. It was evidenced that residents always have a choice of meals. The recently refurbished dining room is now well-decorated, clutter free and aesthetically pleasing. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents feel confidant that any concerns or complaints will be listened to, taken seriously and acted upon by the manager and staff at the home. Residents are protected from abuse. EVIDENCE: Tuxford Manor benefits from clear policies and protocols provided by Hallmark Healthcare in relation to the reporting of concerns and complaints, the complaints procedure is available in the home foyer for residents and their representative’s perusal. At the time of the inspection no complaints were being investigated at the home and no complaints have been received at the Commission for Social Care Inspection. The case tracked residents spoken with stated they felt safe within the home, and should they have any concerns or complaints they would feel confidant in discussing them with the manager or indeed any members of staff at the home. A staff member was spoken with at the time of the inspection and it was evident that she had and appropriate knowledge of the complaints procedure utilised at the home. The member of staff was also aware of adult protection issues. She stated that if she suspected that abuse was happening in the home Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 16 or an allegation of abuse was made she would inform the manager who would contact Social Services, the Commission for Social Care Inspection, the Adult Protection team or the Police if necessary. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents live in a safe well-maintained environment. The home is clean, pleasant and hygienic throughout. EVIDENCE: The home has benefited from a resent refurbishment and on the whole the home has a high standard of cleanliness throughout and all areas smelt fresh. All communal areas, which included the dining room, television lounges and quiet rooms are now well-decorated and fit for purpose with no obvious hazards evident. The case tracked residents gave the inspector consent to examine their bedrooms. The bedrooms were found to be personalised, homely, safe and met the residents individual needs and aspirations. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 18 The home benefits from large, very pleasant garden areas, which are tidy and well maintained. The garden area is also easily accessible to residents in wheelchairs. A case tracked resident stated that he enjoyed sitting out in the garden especially on hot days. The resident went on to say that staff at the home would provide refreshing drinks throughout the day as required. It was evident that some improvements within shower room one will be required as some wall tiles were missing and the shower room would also benefit from redecoration. The manager stated that the poor condition of the shower room will be addressed and it is planned that the area will be upgraded in the near future. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staffing levels at the home are appropriate in meeting the needs of the residents. The home utilises an appropriate recruitment policy, which is adhered to thus ensuring residents are supported and protected. Staff receive appropriate training to do their jobs effectively to ensure that residents are in safe hands. EVIDENCE: The staff rota evidenced that an appropriate number of staff were on duty throughout the 24-hour period. The recruitment documentation of the last two members of staff to be employed at the home was checked and found to be satisfactory. Both staff members had undergone appropriate Criminal Record Bureau (CRB) checks and had provided two written satisfactory references. The documentation is well organised and clear. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 20 All staff receive an induction programme, which commences on the first day of employment. It was evidenced that staff also benefit form yearly mandatory training which includes Health and Safety, Moving and Handling, Infection Control, Protection of the Vulnerable Adults, Fire Training, Food Hygiene, First Aid training and the management of challenging behaviours. A senior carer spoken with confirmed that the training opportunities provided at the home are comprehensive in providing information and guidance for staff within the home thus providing a safe environment for residents and staff alike. The manager also ensures that all staff receive appropriate supervision sessions in which staff can discuss any concerns they might have and identify training opportunities available to further enhance the care provision within the home. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35,38. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The manager of the home is suitably qualified to perform the management role. The home is run in the best interests of the residents and their health and welfare is promoted and protected. Residents are protected from financial abuse and their financial interests are safeguarded. Routine maintenance at the home is effective in maintaining the residents and staff health and safety. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager of the home was formally interviewed by the Commission for Social care Inspection on 14th December 2006 and was assessed as competent in performing the manager’s role at Tuxford Manor. Both residents and staff alike made many positive comments about the manager’s abilities together with her management techniques. It was evident that the management style has resulted in a good team spirit, and a stable, relaxed, environment. Residents and staff stated that the manager is very amenable and she operates an open door policy so that any concerns that residents and staff might have are listened to and addressed effectively. In ensuring that the home is run in the best interests of the residents formal residents meetings are held on a three monthly basis. The residents meetings, which are facilitated by the manager provides a forum in which any concerns can be identified and addressed effectively. In protesting the resident from financial abuse it was established through conversations with the manager that residents monies are individually stored and appropriate policies and procedures are adhered to thus protecting the residents from financial abuse. The monies of the case tracked residents were examined and found to be correct. Additional services such as hairdressing, daily newspapers and Podiatry interventions are not included in the homes fees. To ensure that the residents are safe within the homes environment a range of Health and Safety records were seen, all were found to be satisfactory. It is evident that all documentation appertaining to the routine maintenance within the home is well organised by the manager and her maintenance technician and are easily accessible. Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP3 OP7 Good Practice Recommendations The registered person should ensure that a holistic needs assessment is performed on all residents at Tuxford Manor. The registered person should as far as practically possible ensure that residents or their relatives are involved in the care planning process to make certain informed consent is obtained in relation to the content of the care plans. The registered person should ensure that elements of care identified within the care plans are effectively evaluated. The registered person should ensure that shower room one is refurbished and the tiles repaired together with the small area of flaking paint. 3 4 OP8 OP19 Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tuxford Manor Care Home DS0000063842.V302562.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!